Similar Drugs

Wellbutrin is the brand name for bupropion, a prescription
antidepressant drug thatâ€™s used to treat depression and seasonal
affective disorder â€” a type of
depression that usually strikes in the fall and winter.

Under the brand name Zyban, bupropion has also been prescribed to help
people quit smoking. Wellbutrin and Zyban, both made by
GlaxoSmithKline, should not
be taken together.

Available as a standard pill and in a sustained-release or long-acting
extended-release tablet, Wellbutrin belongs to the aminoketone class of
antidepressants, which are chemically unrelated to the better-known
selective-serotonin reuptake inhibitors (SSRIs), such as Prozac, Paxil,
or Zoloft.

Wellbutrin mobilizes the brain chemicals norepinephrine and dopamine,
but exactly how it works to treat depression is not known.

The Food and Drug Administration (FDA) originally approved Wellbutrin
as a treatment for depression in 1985, but it was withdrawn from the
market in 1986
amid findings that it increased the frequency of seizures in
non-depressed bulimic patients at the originally recommended dose of
400-600 milligrams a day.

The FDA reapproved Wellbutrin in 1989 with a lowered daily dose and a
warning about the increased risk of seizures. It approved the
sustained-release
version of Wellbutrin in 1996 and the extended-release version in 2003.
In 2006, Wellbutrin was the first drug the FDA approved for the
treatment of
seasonal affective disorder.

Wellbutrin (Bupropion) Warnings

Since 2004, Wellbutrin, like other antidepressants, is required to
carry a "black box" warning about an increased risk of suicidal
thinking and behavior in
children, teenagers, and young adults between the ages of 18 and 24,
and about the need to monitor patients taking antidepressants for signs
of any
worsening of their depression, and for the emergence of suicidal
thoughts, especially in the first few months of treatment, or when the
dose is either
increased or decreased.

The "black-box" warning also extended to Zyban, which contains the same
ingredient as Wellbutrin and is made by the same company (Wellbutrin is
not
FDA-approved as a smoking-cessation aid in the United States).

You should tell your doctor about all the prescription and
over-the-counter drugs, vitamins, illegal and recreational drugs, and
dietary supplements you're
taking, especially if you're on monoamine oxidase inhibitors (MAOIs),
such as Marplan (isocarboxazid), Nardil (phenelzine sulfate), the
antibiotic Zyvox
(linezolid), or whether you stopped taking one of these drugs in the 14
days before you begin taking Wellbutrin.

People who have had a seizure or epilepsy, an eating disorder such as
bulimia or anorexia nervosa, or are using or withdrawing from alcohol
or certain
drugs used to treat anxiety, seizures, and insomnia such as Xanax,
Valium, and Ativan, are generally not good candidates for Wellbutrin.

Also be aware that Wellbutrin can cause false-positive urine tests for
amphetamines.

Your doctor also needs to know if you have liver or kidney disease
(which would require certain precautions), are taking insulin for
diabetes, are taking
other antidepressants, or are using a nicotine patch, which can
increase the risk of high blood pressure.

Pregnancy and Wellbutrin (Bupropion)

Wellbutrin is in Pregnancy Category C, according to the FDA, which
means that harm to a womanâ€™s fetus cannot be ruled out. Nonetheless,
the drugâ€™s benefits
to the mother may outweigh the potential risks to her developing fetus.

Data from population studies of pregnant women taking Wellbutrin in the
first trimester indicated no increased risk of congenital
malformations. A 2010
study in the American Journal of Obstetrics and Gynecology suggested a
link between Wellbutrin taken in the first trimester and congenital
heart defects
but found that more data was needed to confirm a connection.

Wellbutrin is present in breast milk, and thereâ€™s some evidence that it
may cause seizures in babies; it may also reduce the amount of breast
milk a mother
produces.

Wellbutrin (Bupropion) Interactions

Wellbutrin (Bupropion) and Alcohol

Drinking alcohol when taking Wellbutrin should be avoided or at least
minimized, although reports of worsening psychiatric or neurological
conditions or
lowered alcohol tolerance in patients who drink while on Wellbutrin
have been rare.

Wellbutrin (Bupropion) and Drug Interactions

Interactions with the following drugs are possible:

Paroxetine (Paxil)

Sertraline (Zoloft)

Fluoxetine (Prozac)

Diazepam (Valium)

Clopidogrel (Plavix)

Ticlopidine (Ticlid)

Orphenadrine (Norflex, Banflex)

Carbamazepine (Tegretol)

Clotrimazole (Canesten, Lotrimin)

Rifampicin (Rifadin)

Ritonavir (Norvir)

Lopinavir (Kaletra)

Elfavirenz (Sustiva)

St. John's wort

Phenobarbital (Luminal)

Caramazepinen (Carbatrol, Tegretol,
Equetro, Epitol)

Phenytoin (Dilantin, Phenytek)

Venlafaxine (Effexor)

Nortriptyline (Pamelor)

Imipramine (Tofranil)

Desipramine (Norpramin)

Haloperidol (Haldol)

Risperidone (Risperdol)

Thioridazine (Sonapax, Thioril)

Metropolol (Lopressor)

Propafenone (Rythmol)

Flecainide (Tambocor)

Extreme caution must be used when taking Wellbutrin with other drugs
that lower the "seizure threshold," such as other products containing
bupropion,
antipsychotic medications, other antidepressants, drugs used for
respiratory problems, or certain corticosteroids that may be taken for
asthma.

Wellbutrin (Bupropion) and Other Interactions

Wellbutrin may be taken with or without food. Don't drive or operate
dangerous machinery until you know how the medication affects you.

Wellbutrin (Bupropion) Dosage

Wellbutrin comes as a standard pill of 75 milligrams (mg) and 100 mg,
as a sustained-release pill (100 mg), and as a long-acting
extended-release tablet
(150 and 300 mg). The starting dose is usually 200 mg a day, given in
two doses of 100 mg. After three days, your doctor may increase the
dose to 300 mg a
day, given as 100 mg three times a day, with at least a six-hour
interval between doses. To minimize the risk of seizure, the dose must
be increased
gradually. The maximum dose is 450 mg a day. The extended-release
version is usually taken once a day in the morning within a 24-hour
time frame.

Try to take Wellbutrin at the same time every day, and avoid taking it
too close to bedtime.

Swallow the pills whole â€” do not split, chew, or crush them.

Be aware that it might take a month or more to feel improvement from
the drug. Continue to take it, and don't go off Wellbutrin without
consulting your
doctor. Stopping the drug too abruptly can result in "discontinuation
syndrome," which shows up as repetitive, uncontrollable twisting of a
part of the
body, irritability, anxiety, mania, and headaches.

Make sure you are not taking more than one product containing the
generic bupropion at one time, as that could result in an overdose.

Wellbutrin (Bupropion) Overdose

An overdose of Wellbutrin is considered moderately dangerous. Deaths
have been reported, but they're rare.

Symptoms of an overdose can include:

Hallucinations and delusions

Vomiting

Aggressive behavior

Rapid heart beat

Seizures

Call a poison control center or get to an emergency room if you believe
you've overdosed. If a person taking Wellbutrin has collapsed or is not
breathing,
call 911 immediately.

The safety and effectiveness of Wellbutrin has not been determined in
children younger than 18. No overall differences in Wellbutrin's safety
or
effectiveness were found in those older than 65.

If You Miss a Dose of Wellbutrin (Bupropion)

Skip the missed dose, and get back on schedule when it's time for the
next dose. You must allow the full six-hour interval between doses. Do
not double up
on doses to recoup the missed one.

Wellbutrin FAQ

Q: Do Wellbutrin and Pristiq taken together cause weight gain?

A: Both medications show the possibility of causing weight gain, but they tend to promote weight loss instead. However, it is possible when taken together they will cause weight gain in some individuals.

Q: I have been on Wellbutrin for about 5 to 6 years, and I've gained 55 pounds. Is this common?

A: Although it is possible to gain weight while on Wellbutrin, it is more likely to see patients lose weight while taking the medication. It was found in clinical studies that the group of patients not taking Wellbutrin actually gained more weight over time than the patients taking the medication.

Q: What is the maximum daily dose a doctor can prescribe for Wellbutrin? I am currently taking 300 mg per day for depression/anxiety and to also help with withdrawal symptoms from trying to quit smoking, and I don't feel that it is working.

A: According to the prescribing information available for Wellbutrin (bupropion), the maximum daily dose ranges from 300mg/day to 450mg/day depending on what is being treated and which formulation of the drug has been prescribed. If you are concerned that Wellbutrin (bupropion), at the prescribed dose, is not working optimally, you may want to contact your health care provider to discuss other treatment options. For additional information regarding Wellbutrin, you may want to visit our Web site or subscribe to our Emotional Health newsletter. Please see http://www.everydayhealth.com/drugs/wellbutrin.

Q: Does Wellbutrin cause weight gain in women?

A: Changes in weight and appetite are common side effects of Wellbutrin (bupropion). Some patients find that switching to another antidepressant can help with weight gain. Consult your healthcare provider to determine if switching medications is appropriate based on your specific circumstances. Do not stop or change the amount of medication you take without talking to your healthcare provider first. Suddenly stopping Wellbutrin can lead to withdrawal side effects. You may also find helpful information at http://www.everydayhealth.com/drugs/wellbutrin and http://www.everydayhealth.com/weight/calories.aspx Sarah Lewis, PharmD

Q: I have been on Wellbutrin XL 300 mg daily for 3 months. Can Wellbutrin XL cause panic attacks? Can I go off it cold turkey? My doctor said that it was one that you could.

A: Wellbutrin (buproprion) is an antidepressant medication. With most antidepressant medications abrupt withdrawal should be avoided or potentially serious side effects could result. Wellbutrin (buproprion) does not tend to cause the withdrawal symptoms that other antidepressants can, so it is generally okay to stop Wellbutrin (buproprion) without having to slowly taper off. Like all antidepressants, Wellbutrin (buproprion) carries a black box warning of the increased risk of suicidal thinking and behavior especially in young adults (less than 24 years). All patients need to be monitored for changes in behavior in the first few months of starting Wellbutrin (buproprion). According to Lexi-Comp and the package insert, Wellbutrin (buproprion) has the possibility of causing such side effects as agitation, anxiety, hostility, nervousness and irritability. If you have these or other changes in mood or behavior you should contact your healthcare provider immediately. It is also important to talk with your healthcare provider before stopping or starting any medications. Please see the following Everyday Health link for more information on Wellbutrin (buproprion). http://www.everydayhealth.com/drugs/wellbutrin
Laura Cable, PharmD

Q: Is Wellbutrin XL long-acting?

A: Wellbutrin (bupropion) comes in several different formulations. Wellbutrin (bupropion) is immediate-release and can be dosed up to three times a day. Wellbutrin SR (bupropion sustained-release) is dosed twice a day. Wellbutrin XL (bupropion extended-release) is only to be dosed once a day. Wellbutrin XL (bupropion extended-release) is meant to last for 24 hours. If Wellbutrin XL does not seem to be doing the job your health care provider may be able to increase the dose, depending on what dose you are currently on. Be sure to talk to your healthcare provider about any problems you may be having to determine if a change of dose or a change in medication is needed. Please see the following Everyday Health link for more information on Wellbutrin XL. http://www.everydayhealth.com/drugs/wellbutrin-xl

Q: What's the difference between Wellbutrin XR and Wellbutrin SR?

A: Wellbutrin (bupropion) SR is usually taken twice a day, while XR is normally a once-a-day dose. The manufacturer claims it is easier to remember to take a medication once a day than more frequently. It will be up to your health care provider to determine which form of this medication would be best to use when treating a medical condition.
Gerry Levy, RPh

Q: What are the side effects of Wellbutrin 100 mg?

A: Here are some of the side effects of Wellbutrin. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have a seizure (convulsions) or fast, uneven heartbeats. Less serious side effects may be more likely to occur, such as: headache or migraine, nausea, vomiting, constipation, dry mouth, confusion, dizziness, tremors (shaking), appetite changes, weight loss or gain, mild itching or skin rash, increased sweating; or loss of interest in sex. This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effects. It is important to consult with your physician or healthcare provider about any specific questions regarding your medical conditions or medications; particularly before taking any action.
Kristen Dore, PharmD

Q: I have been on brand-name Wellbutrin and had to change to a generic. It's just not the same. Two of my friends are also sensing this with generic Wellbrutrin. Could there be a difference between brand and generic?

A: The first thing that you need to do is get a letter from your physician to your insurance carrier stating that you need to have brand-name Wellbutrin. Second, you need to report to the Food and Drug Administration that generic Wellbutrin is not having the same effect for you and let them know any additional side effects. The FDA has a hotline at 800-332-1088. The generic formulation most likely needs to be retested. This is often a problem with sustained-release formulations, although some generic companies are able to get it right.
Matt Curley, PharmD

Q: My 16-year-old daughter is starting to take Wellbutrin. The dosage is 150 mg. Is that high for a starting dose?

A: According to the prescribing information for Wellbutrin, it is indicated for use in adults. The initial starting dose in adults that is recommended is 150 mg daily. This information is solely informational. It's important to consult with your physician or health care provider about any specific questions regarding your medical conditions or medications; particularly before taking any action. Kristen Dore, PharmD

Q: I am taking Wellbutrin XL 300 mg daily for depression. How can I tell if the medication is still as effective? I still am feeling down, and wonder if maybe this is not helping? Can you build up a tolerance after a while? I have been on it for over 4 months now.

A: Wellbutrin XL (bupropion hydrochloride extended-release tablets) is a prescription medicine used to treat adults with a certain type of depression called major depressive disorder and for prevention of autumn-winter seasonal depression (seasonal affective disorder). If you are taking Wellbutrin XL for the treatment of major depressive disorder, it may take several weeks for you to feel that Wellbutrin XL is working. Once you feel better, it is important to keep taking Wellbutrin XL exactly as directed by your doctor. Call your doctor if you do not feel Wellbutrin XL is working for you. For more specific information, consult with your doctor or pharmacist for guidance based on your specific condition and current medications. Shereen A. Gharbia, PharmD

Q: Can Wellbutrin cause weight gain?

A: Wellbutrin (bupropion) immediate-release formulation may cause weight loss of about five pounds in 28 percent of patients. The sustained-release formulation may cause weight loss in about 15 percent of the patients. Up to 25 percent of patients on the XL formulation lost greater than five pounds. It is very unlikely Wellbutrin will cause weight gain. Weight gain is often noticed in patients whose depression is not controlled. Please see http://www.everydayhealth.com/drugs/wellbutrin/side-effects. Lori Mendoza, PharmD

Q: My husband's prescription of Wellbutrin went from $22.00 per month to $82.00. Is there a generic he can take?

A: Wellbutrin(bupropion hcl) dose have a generic form on the market. Check with your pharmacy about getting the generic version on the market. Co-p drugsays are usually much higher for brand name over generics. They may have to check with your physician to see if they can substitute the brand for the generic and it depends on your state laws. Once you are placed on the generic, tell you pharmacy that you want the same brand each time as it may give you better results in the long run than switching from brand to brand. Hope this has been of some help to you. Gerald R. Levy, RPh

Q: Are there vitamins, minerals, or herbs that I should not take with Wellbutrin?

A: Your question regards if there are vitamins, minerals, or herbs that should be avoided when taking Wellbutrin (bupropion) http://www.everydayhealth.com/drugs/wellbutrin'>http://www.everydayhealth.com/drugs/wellbutrin. The answer is yes. However, it would be best for you to provide us with a list of the vitamins, minerals, herbs that you are either taking or considering taking so that we can perform a drug interaction report. If you would like to supply us with that information, then please follow this link: http://www.everydayhealth.com/drugs/ and resubmit your question with more specific information. Examples of some of the herbs and neutraceuticals that should be avoided while taking Wellbutrin according to Lexi-Comp include: valerian, St. John's wort, SAMe, gotu kola, and kava kava. Jen Marsico, RPh

Q: I take 150 mg of Wellbutrin XL daily with 5000 mg with vitamin D3. Is this okay?

Q: I took one Wellbutrin SR last night, and today I am so nervous I could jump out of my skin. Should I not take it anymore?

A: Some patients experience worsening symptoms or thoughts of suicide when they first start taking an antidepressant. If you experience mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive or agitated and restless, contact your health care provider. For more information on Wellbutrin, please visit http://www.everydayhealth.com/drugs/wellbutrin. Michelle McDermott, PharmD

Q: Can the generic form of Wellbutrin make someone lethargic or tired? I feel tired and sore a lot and very sluggish.

A: Theoretically the generic form of Wellbutrin (bupropion) should have the same side effects as the brand-name product, because they contain the same active medication. Somnolence (drowsiness) has been reported in 2 percent to 3 percent of patients studied who were taking Wellbutrin. Pain is also listed as a possible adverse reaction in 2 percent-3 percent of patients. As always, talk with your health care provider regarding questions you have about your medications and possible side effects. Jen Marsico RPh

Q: I know Wellbrutin is an antidepressant but does it also help you lose weight or keep your weight down?

A: According to the package insert, Wellbutrin can cause changes in weight or appetite. These changes have included both weight loss and weight gain. In scientific studies, 13.6 percent of patients taking Wellbutrin reported weight gain compared with 22.7 percent of patients taking placebo (sugar pill) and 23 percent of patients taking Wellbutrin reported weight loss compared with 23 percentof patients taking placebo. For more information, please consult with your health care provider and visit http://www.everydayhealth.com/drugs/wellbutrin. You are encouraged to report any negative side effects of prescription drugs to your health care practitioner and the Food and Drug Administration (FDA) by visiting www.fda.gov/medwatch, or by calling 1-800-FDA-1088. Michelle McDermott, PharmD

Q: What is the difference between Wellbutrin SR and Wellbutrin XR? My son takes two doses of Wellbutrin SR (150mg each) but frequently forgets to take the afternoon dose. Is is possible to take one dose of Wellbutrin XR (300mg) and get the same relief?

A: Originally, Wellbutrin (buproprion) was in a non-sustained release tablet form and needed to be taken 3 times a day. Then they came out with the Wellbutrin SR which allowed twice a day dosing. For some people once a day dosing worked with this formulation. Eventually, Wellbutrin went generic and several companies started making "SR" or the twice a day dosing, so GSK decided to make a once a day dosing formulation (known as either XR or XL) The once a day dosing can vary from patient to patient as everyone has different bowel patterns. Obviously if the medication does not stay in your gut for the entire day, then it will probably have some diminished effectiveness. For your son, I would suggest getting samples to help determine whether he is getting the same coverage with the Wellbutrin SR. That obviously beats investing in a whole prescription to find out that it may not. Feel free to visit here for more information: http://www.everydayhealth.com/drugs/wellbutrin Matt Curley, PharmD

Q: How difficult would it be or what are the side effects of getting off Welbutrin XL 150 mg?

A: When antidepressants or other medicines for mental illnesses are stopped abruptly, symptoms may return and the illness may be harder to treat. In addition, withdrawal symptoms are possible. A review of medical literature showed a report of withdrawal symptoms in a person being treated with Wellbutrin (bupropion). The symptoms included irritable mood, anxiety, sleeplessness, headache, and generalized aches and pains. To relieve these symptoms, the doctors restarted bupropion and then slowly tapered the dose down over two to three weeks. According to the package insert, it is recommended that patients gradually reduce the dose of antidepressant rather than stopping the medication abruptly. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, doctors may continue decreasing the dose but at a more gradual rate. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Michelle McDermott, PharmD

Q: Can Wellbutrin cause weight gain? I have been on it for 12 years and at 300 mg a day for three years now. I am going off it gradually.

A: Wellbutrin (bupropion) is an antidepressant. Appetite changes, both increased and decreased, have been reported by patients taking Wellbutrin. The exact relationship between antidepressants and weight gain isn't clear, but weight gain is a reported side effect of nearly all antidepressants. There are many factors that can work together to contribute to weight gain during antidepressant therapy. Some people lose weight as part of their depression. In turn, an improved appetite associated with improved mood may result in increased weight. Overeating as a result of depression also can cause weight gain. In addition, some medical conditions that mimic depression

Q: How difficult is it to stop Wellbutrin? I'm taking 450 mg a day, along with Cymbalta 60 mg, Topamax 300 mg, Seroquel 200 mg and Klonopin 1 mg? What are the bad side effects. Can my depression return if I go off slowly?

A: There is a moderate drug-drug interaction between Wellbutrin and Cymbalta, Topamax, Seroquel and Klonopin, which results in a lowering of the seizure threshold. The risk of seizures may be increased in patients with a history of head trauma or prior seizure; CNS tumor; severe hepatic cirrhosis; excessive use of alcohol or sedatives; addiction to opiates, cocaine, or stimulants; use of over-the-counter stimulants and anorectics; a total daily dose of Wellbutrin greater than 450 mg or single doses greater than 150 mg; rapid escalation of bupropion dosage; diabetics treated with oral hypoglycemics or insulin; or with concomitant medications known to lower seizure threshold (antipsychotics, theophylline, systemic steroids). The adverse effects associated with Wellbutrin are dry mouth, nausea, insomnia, tremor, excessive sweating, rash and tinnitus. As with any medication of this type, discuss how to appropriately discontinue treatment with Wellbutrin with your physician. A gradual dosage decrease is preferable to just stopping the medication. I do not know your medical history to advise you if depression will return. For immediate questions or concerns, please contact your physician. Joseph Hall, RPh

Q: What are the long term effects of taking Wellbutrin? What about the effects of Celexa?

A: Wellbutrin (bupropion) became available to the public in the United States in 1989 and has become a commonly used antidepressant. bupropion is approved for use in major depression and seasonal affective disorder and has demonstrated comparable efficacy to other antidepressants in clinical trials. bupropion is also useful in augmenting a partial response to selective serotonin reuptake inhibitor (SSRI) antidepressants, although bupropion should not be combined with monoamine oxidase inhibitors. It may be less likely to provoke mania than antidepressants with prominent serotonergic effects. bupropion is effective in helping people quit tobacco smoking. Anecdotal reports indicate bupropion may lower inflammatory mediators such as tumor necrosis factor-alpha, may lower fatigue in cancer and may help reduce concentration problems. Studies have shown that the biggest problem associated with buproprion is a risk of seizure four times higher than with other antidepressants. Overdosing is a particular danger, since the chance of a seizure increases almost tenfold at twice the normal daily dose of 300 mg. The biggest risk for developing a seizure appears to be after a prior serious head injury or prior seizures, brain or spinal-cord tumors, if anti-seizure medication is taken , or if the dosage is suddenly increased. The risk may be lowered if the dosage is not suddenly increased. The most common side effects of Celexa (citalopram) are nausea, diarrhea, vomiting, stomach pain, drowsiness, excessive tiredness, uncontrollable shaking of a part of the body, excitement, nervousness, muscle or joint pain, dry mouth, excessive sweating, changes in sex drive or ability, and loss of appetite. Some side effects can be serious. If you experience any of the following symptoms call your doctor immediately: seeing things or hearing voices that do not exist, fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness, or seizures. Loss of effect of antidepressant therapy appears to occur with most or all antidepressants. Causes of relapse are mostly unknown, with the exception of treatment non-compliance, and may relate to disease factors, pharmacologic effects, or a combination of these factors. Be sure to seek the advice of a qualified medical or mental health professional before making any changes in your medication regimen. For more information: http://www.everdayhealth.com/DrugsAZ/Wellbutrin.aspxhttp://www.everydayhealth.com/depression/understanding.aspx

Q: Is it possible for depression symptoms to return even though I am taking my Wellbutrin XL as prescribed?

A: Wellbutrin (bupropion) (www.everydayhealth.com/drugs/wellbutrin) is an antidepressant that works on chemicals in the brain. Wellbutrin is indicated for depression. (http://www.everydayhealth.com/depression/understanding.aspx). Side effects of Wellbutrin include headache, insomnia, nausea, dizziness, appetite changes and tremor or shaking. (http://www.everydayhealth.com/emotional-health/index.aspx). This is not a complete list of side effects associated with Wellbutrin, consult with your doctor if your depression is worsening or not controlled with the Wellbutrin. Do not discontinue any medication without consulting with a doctor. Kimberly Hotz, PharmD.

Q: Does Wellbutrin cause bad dreams? Recently, I was switched to it and have noticed dream patterns to be more vivid.

A: Wellbutrin (bupropion) is an antidepressant that is used to treat depression. The most common side effects with Wellbutrin are dry mouth, headache, agitation, nausea, dizziness, constipation, and tremor. Other side effects with Wellbutrin include sweating, abnormal dreams, insomnia, and weight loss. This is not a complete list of the side effects associated with Wellbutrin. For more specific information, consult your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your healthcare providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Tell your health-care provider about any negative side effects from prescription drugs. You can also report them to the U.S. Food and Drug Administration by visiting www.fda.gov/medwatch or by calling 1-800-FDA-1088. Megan Uehara, PharmD

Q: My 16-year-old daughter is starting to take Wellbutrin. How do I know how high a dosage is right?

A: The starting adult dose of Wellbutrin is 150 mg daily. It's important to discuss your teen's particular medical situation and needs with her health care provider to determine the dosage that's right for her. Kristen Dore, PharmD

Q: For the past four months, I've been taking Wellbutrin daily for depression. How can I tell if the medication is still effective? I still am feeling down. Can you build up a tolerance after awhile?

A: Wellbutrin (bupropion) is a prescription medicine used to treat adults with a certain type of depression called major depressive disorder. It can also help prevent autumn-winter seasonal depression (seasonal affective disorder). If you're taking Wellbutrin for major depressive disorder, it may take several weeks for you to feel that it's working. Once you feel better, it's important to keep taking the Wellbutrin exactly as directed by your doctor. Call your doctor if you don't think the Wellbutrin is working for you. Shereen A. Gharbia, PharmD

Q: What are the long-term effects of taking Wellbutrin? How about any effects from taking Celexa?

A: Wellbutrin (bupropion) is an antidepressant in the dopamine-reuptake inhibitor class of drugs. It's also sometimes used to help quit smoking. The most common side effects of Wellbutrin include increased heart rate, headache, insomnia, dizziness, weight loss, nausea, dry mouth, and pharyngitis. It may also increase the risk of seizures and, like all antidepressants, it carries the warning of increased risk of suicide in young adults. Wellbutrin should be avoided in patients with eating disorders. Celexa (citalopram) is an antidepressant in the drug class of selective serotonin reuptake inhibitors (SSRIs). Its most common side effects include drowsiness, insomnia, nausea, dry mouth, and sweating. SSRIs are more likely to cause sexual side effects than Wellbutrin. Celexa carries the same warning about suicide risk as does Wellbutrin. For more information on these drugs, go to http://www.everydayhealth.com/drugs/wellbutrin and http://www.everydayhealth.com/drugs/celexa. Laura Cable, PharmD

Q: Are there side effects to taking generic wellbutrin vs brand name? A doctor on Dr. Oz mentioned hand tremors. Is there a differnce between manufacturers of the generic? What about Sandoz?

A: Wellburin (bupropion) (www.everydayhealth.com/drugs/wellbutrin) is an antidepressant that works on chemicals in the brain. Wellbutrin is indicated for depression. Side effects of Wellbutrin include headache, insomnia, nausea, dizziness, appetite changes and tremor or shaking. (http://www.everydayhealth.com/emotional-health/index.aspx). This is not a complete list of side effects associated with Wellbutrin consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Tell your health-care provider about any negative side effects from prescription drugs. You can also report them to the U.S Food and Drug Administration by visiting http://www.fda.gov/medwatch or by calling 1-800-FDA-1088. Generic drugs are lower-cost alternatives to more expensive brand-name drugs. They will appear different and have a few other minor differences from the brand-name drugs, but their labeling and directions for use must be virtually the same as that of the brand name product. Both brand-name and generic drug manufacturing facilities must follow the same standards of good manufacturing practices and meet the U.S. Food and Drug Administration

Q: I already take One-A-Day Essential Daily Vitamins, which contains vitamin C 60 mg, vitamin D 400 IU, vitamin E 30 IU, calcium 45 mg. I also take calcium 1200 mg w/D-1000IU, vitamin C 400 mg, omega-3 EPA 400 mg/DHA 200 mg. I also take 400 mg Wellbutrin SR. Should I change my dosages to vitamin C 3000 mg (to reduce the cortisol hormone), vitamin E 400 IU, selenium 100 mg (concerned w/ my Wellbutrin), vitamin D 2000 IU, coenzyme Q10 200 mg, and potassium 3000 mg? I was reading an article, and it suggested that I take what I have listed. Please help clear up my confusion on what I should take as a daily regimen, taking in consideration of my Wellbutrin prescription. My eating habits are good to very good.

A: According to the National Institutes of Health, the best way to get enough vitamins is to eat a balanced diet with a variety of foods. In some cases, a daily multivitamin may be needed for optimal health. There are numerous formulations and different combinations of vitamins and minerals. The need for vitamin supplementation and the choice of the most appropriate vitamin preparation may depend on many patient-specific characteristics. Thus, it is important to consult with your physician or health care provider regarding the intake of vitamins. Because herbs and supplements are not strictly regulated by the U.S. Food and Drug Administration, these products are not required to be tested for effectiveness, purity, or safety. In general, dietary supplements should only be taken under the supervision of your health care provider. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. There are no known interactions between vitamins and Wellbutrin (bupropion) that we are aware of. The herbal supplements St. John's wort, 5HT, and SAM-e should not be taken with any antidepressants because they work on the same chemicals in the brain (serotonin and norepinephrine). For more information on Wellbutrin, visit http://www.everydayhealth.com/drugs/wellbutrin. Lori Poulin, PharmD

Q: Does Wellbutrin cause weight gain, or prevent weight loss?

A: Wellbutrin (bupropion) is classified as a dopamine reuptake inhibitor antidepressant and as a smoking cessation aid. Wellbutrin is approved for the treatment of depression and as an adjunct in smoking cessation. According to medical references, weight gain is not a common side effect reported by studied patients taking Wellbutrin. However, weight loss is a common reported side effect of patients taking Wellbutrin. The incidence of the number of patients that reported weight loss was between 14% to 23% of studied patients. If you think that you are experiencing a side effect from a medication, talk to your physician. Do not stop taking or change the dose of the medication without first talking to your physician. If you are trying to lose weight, Everyday Health provides valuable information about weight. Click here to access the articles. Jen Marsico, RPh

Q: Can Wellbutrin cause weight loss?

A: Wellbutrin (bupropion) is an antidepressant medication. It is used to treat major depression and seasonal affective disorder. Common side effects of Wellbutrin include weight changes (loss or gain), headache, insomnia, nausea, vomiting, constipation, dry mouth, dizziness, tremors, appetite changes, increased sweating, and loss of interest in sex. Consult your doctor if weight loss continues or becomes severe. This is not a complete list of the side effects associated with Wellbutrin. Sarah Lewis, PharmD

Q: Can Wellbutrin cause excessive itching?

A: Wellbutrin is in a drug class called antidepressants. Wellbutrin is used to treat adults with major depressive disorder. In addition, Wellbutrin XL is also used to prevent seasonal affective disorder (SAD), which is a type of depression that occurs during the fall and winter. Wellbutrin works by increasing certain chemicals in the brain that assist in keeping a healthy mental balance. The exact mechanism is not known, but Wellbutrin may affect dopamine and norepinephrine levels. According to the prescribing information, itching may be a sign of an allergic reaction to Wellbutrin. Contact your health care provider, especially if the itch is accompanied by rash, hives, fever, swollen lymph glands, sores in the mouth or around eyes, swelling of the lips or tongue, chest pain, or trouble breathing. Other side effects from Wellbutrin may include: seizures, trouble sleeping, nausea and vomiting, dizziness, tremors, constipation, loss of interest in sex, and increased sweating. This is not a complete list of the side effects associated with Wellbutrin. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Tell your health care provider about any negative side effects from prescription drugs. You can also report them to the U.S. Food and Drug Administration by visiting www.fda.gov/medwatch or by calling 1-800-FDA-1088. Kristen Dore, PharmD

Q: I know Wellbutrin is an antidepressant. Does it also help you lose weight or keep your weight down?

A: Wellbutrin (bupropion) is used to treat depression. According to the package insert, Wellbutrin can cause changes in weight or appetite. These changes have included both weight loss and weight gain. In scientific studies, 13.6% of patients taking Wellbutrin reported weight gain compared with 22.7% of patients taking placebo (sugar pill) and 23% of patients taking Wellbutrin reported weight loss compared with 23% of patients taking placebo. For more information, please consult with your health care provider and visit http://www.everydayhealth.com/drugs/wellbutrin. You are encouraged to report any negative side effects of prescription drugs to your health care practitioner and the Food and Drug Administration (FDA) by visiting www.fda.gov/medwatch, or by calling 1-800-FDA-1088. Michelle McDermott, PharmD

Q: I take Budeprion every day. Can it have any effect on my skin?

A: Wellbutrin or Budeprion (bupropion) is an antidepressant that works on chemicals in the brain. Side effects include headache, insomnia, nausea, dizziness, appetite changes, and tremor or shaking. Mild itching or skin rash and increased sweating were also reported side effects of bupropion. For more information on this medication, go to www.everydayhealth.com/drugs/wellbutrin. Kimberly Hotz, PharmD

Q: I have heard that the generic form of Wellbutrin XL 300 mg is not nearly as good as the brand name. Is that true? There is no problem with the 150 mg, however.

A: Generic drugs provide Americans with lower-cost alternatives to the escalating costs of brand name drugs. In general, generics may differ in such characteristics as shape, scoring configuration, release mechanisms, packaging, excipients, expiration date/time, and minor aspects of labeling and storage conditions. With the exception of language protected by patents or exclusivity, the labeling of the generic, including directions for use, must be virtually the same as that of the brand name product. Both brand name and generic drug manufacturing facilities have to adopt the same standards of good manufacturing practices and meet the Food and Drug Administration's (FDA) specifications. According to the FDA, generic drugs are identical or within an acceptable bioequivalent range to the brand name counterpart with respect to pharmacokinetic and pharmacodynamic properties. By extension, therefore, generics are considered (by the FDA) identical in dose, strength, route of administration, safety, efficacy, and intended use. For more detailed information, consult with your physician or pharmacist about any concerns and questions related to your medications. Shereen A. Gharbia, PharmD

Q: I have been on Wellbutrin for about 3 years. I don't even think I need it now. How can you successfully wean off of it? I get headaches and literally feel sick when I don't take one tablet. Also, I have been able to take a glass of wine now and then without any problems, but it says no alcohol with the medication. Is it a very serious problem to take wine with it? I heard of a person that ended up in the ER with 3 glasses of wine and Wellbutrin.

A: When antidepressants or other medicines for mental illnesses are stopped abruptly, symptoms may return and the illness may be harder to treat. In addition, withdrawal symptoms are possible. A review of medical literature showed a report of withdrawal symptoms in a person being treated with bupropion (Wellbutrin). The symptoms included irritable mood, anxiety, sleeplessness, headache, and generalized aches and pains. To relieve these symptoms, the doctors treating this patient restarted bupropion and then slowly tapered the dose down over 2 to 3 weeks (1). According to the package insert, there have been rare reports of adverse neuropsychiatric events or reduced alcohol tolerance in patients who were drinking alcohol during treatment with Wellbutrin. The consumption of alcohol during treatment with Wellbutrin should be minimized or avoided. For more information, please consult with your health care provider. Regards, Michelle McDermott, PharmD

Q: Does Wellbutrin have any adverse effects upon diabetics?

A: Your question concerns the safety of Wellbutrin (bupropion) http://www.everydayhealth.com/drugs/wellbutrin use when diabetes (http://www.everydayhealth.com/diabetes/index.aspx) is present. I could find no studies that showed any complication suffered by diabetics using Wellbutrin. It appears to be perfectly safe for use by diabetics. It is always a good idea to check with one's health care provider in matters like this. Please consult your health care provider for guidance in your specific case. Gregory Latham, MS, RPh

Q: I currently take bupropion. There has been much debate over the difference between bupropion (generic) and Wellbutrin. Can I ask my doctor to put me on Wellbutrin just to see if I can tell a difference?

A: Wellbutrin (bupropion) comes in several different forms. Wellbutrin (bupropion) is immediate release and can be dosed up to three times a day. Wellbutrin SR (bupropion sustained-release) is dosed twice a day. Wellbutrin XL (bupropion extended-release) is only to be dosed once a day. Wellbutrin XL (bupropion extended-release) is meant to last for 24 hours. First, you want to be sure you are on the correct generic formulation. You can ask your health care provider to write for you to get the brand name Wellbutrin. However, your insurance may deny the claim since there is a cheaper generic version available. Of course you can always pay cash for the medication if your insurance company will not pay for it. Please see the following Everyday Health link for more information on buproprion. http://www.everydayhealth.com/drugs/bupropion. Laura Cable, PharmD

Q: I am taking 40 mg of Celexa and 200 mg of Wellbutrin. I have had the same dreams for weeks. I have just started the Wellbutrin. Do the recurring dreams have anything to do with my meds?

A: Wellbutrin (bupropion) is a antidepressant medication that works by altering the levels of certain chemicals in the brain. In clinical studies, about 6 percent of people taking bupropion experienced abnormal dreams. Consult your physician if this side effect does not resolve, or if it is not tolerable. The most common side effects of bupropion are change in appetite, dizziness, constipation, drowsiness, dry mouth, headache, sweating, nausea, nervousness, restlessness, taste changes, trouble sleeping, vomiting, and weight changes. Bupropion can cause seizures in some people. Taking SSRIs, like Celexa (citalopram), with bupropion can increase your risk of having a seizure. You should not take bupropion if you have seizures, an eating disorder, or if you have suddenly stopped using alcohol or sedatives. Do not stop taking Celexa or bupropion abruptly, withdrawal symptoms may occur. Bupropion and Celexa can interact with other medications. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects.
Burton Dunaway, PharmD

Q: Can Wellbutrin be taken by itself to treat delayed or absent orgasm/ejaculation?

A: Wellbutrin (bupropion) comes in three forms: 1) Wellbutrin: a regular release tablet; 2) Wellbutrin SR: a sustained-release tablet; and 3) Wellbutrin XL: an extended-release tablet. Wellbutrin, Wellbutrin SR, and Wellbutrin XL are in a drug class called antidepressants. Wellbutrin, Wellbutrin SR, and Wellbutrin XL are used to treat adults with major depressive disorder. In addition, Wellbutrin XL is also used to prevent seasonal affective disorder (SAD), which is a type of depression that occurs during the fall and winter. Wellbutrin, Wellbutrin SR, and Wellbutrin XL work by increasing certain chemicals in the brain that assist in keeping a healthy mental balance. According to the National Institute of Mental Health (NIMH), both depression itself and certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), can lead to sexual dysfunction. Sexual dysfunction side effects can affect greater than half of adults taking SSRIs. Common problems in men are reduced sexual drive, erectile dysfunction, and delayed ejaculation. Reduction in sexual dysfunction symptoms may occur with decreased doses of the offending medication or tolerance to the side effect. In general, changing from one SSRI to another SSRI does not improve sexual dysfunction; however, one study found that the use of Celexa (citalopram) was not associated with sexual dysfunction in people who had these side effects with another SSRI. According to NIMH, there have been reports that adding Wellbutrin (bupropion) or Viagra (sidenafil) to ongoing treatment has improved antidepressant associated sexual dysfunction in men. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Derek Dore, PharmD

Q: I started taking Paxil (paroxetine) in 1998 per my doctor for situational extreme anxiety and major dizziness. I'm taking Wellbutrin now but I get dizzy and depressed, and have headaches. Any suggestions?

A: The Wellbutrin is not approved for use for anxiety and this may be why you are still experiencing high anxiety. Paxil is approved for use for anxiety disorder. You may want to talk to your doctor about Wellbutrin and see if there is another medication that they may want you to try since it is not helping your anxiety. Megan Uehara, PharmD

Q: Does Wellbutrin cause memory problems at higher doses?

A: Wellburin is an antidepressant that works on chemicals in the brain. Side effects of Wellbutrin include headache, insomnia, nausea, dizziness, and appetite changes. An overdose of Wellbutrin can cause symptoms of seizures, muscle stiffness, hallucinations, fainting, and irregular heartbeat. Consult with a physician with mental status changes such as memory loss. Studies do not indicate that memory loss is a common side effect on Wellbutrin. A physician can then determine the best treatment regimen. Kimberly Hotz, PharmD

Q: I have been taking Wellbutrin XL 300 mg (generic) for five months now, and it appears to be causing my hair to fall out. I didn't want to believe it because Wellbutrin has helped me with my depression, but I now see there are forums discussing this unfavorable side effect. If I reduce my dosage, will that help stop the hair loss? Will my body eventually adjust to the drug and stop dropping hair? Or is there anything I can take to counteract the hair loss like vitamins? It took me so long to adjsut to this medication, and I fear switching to something else. I have never had this issue before this drug and have always had thick, full hair.

A: According to Lexi-Comp, there have been reports of alopecia or hair loss during postmarketing and or case reports of patients taking Wellbutrin XL (bupropion). There is very little information available about this possible side effect in clinical research. One research article stated that patients taking medications similar to Wellbutrin XL have seen improvement in hair after stopping the medication and/or lowering the dosage. Keep in mind that hair loss can have many causes besides side effects of medications. Talk with your physician regarding your hair loss for diagnosis and for additional guidance on treatment options.
Jen Marsico, RPh

Q: Will taking Wellbutrin while I'm breastfeeding have any effect on my daughter? I've been taking it for about a month and since starting the medication she seems to be more sleepy than usual. She is five months old and today she couldn't stay awake for more than 30 minutes at a time. She would want to eat and then go back to sleep. I am also experiencing excessive tiredness.

A: Wellbutrin (bupropion) is a prescription medicine used to treat adults with major depressive disorder and for prevention of autumn-winter seasonal depression (seasonal affective disorder). Common side effects reported in studies of major depressive disorder include weight loss, loss of appetite, dry mouth, skin rash, sweating, ringing in the ears, shakiness, stomach pain, agitation, anxiety, dizziness, trouble sleeping, muscle pain, nausea, fast heartbeat, sore throat, and urinating more often. In studies of seasonal affective disorder, common side effects included weight loss, constipation, and gas. Wellbutrin passes through breast milk. It is not known if Wellbutrin can harm the nursing baby. Caution should be exercised when Wellbutrin is administered to a nursing woman. Shereen A. Gharbia, PharmD

Q: I have had lapband surgery and must crush my medications. I can tolerate all my medications, except Wellbutrin, which tastes horrible crushed. I have tried flat soda, juice, applesauce, and ice cream nothing seems to cut the taste. Any ideas?

A: Wellbutrin (bupropion) is a dopamine-reuptake inhibitor antidepressant which is used for the treatment of major depressive disorder. There are long-acting forms of bupropion which are used for smoking cessation and to treat seasonal affective disorder. The long acting forms of Wellbutrin (Wellbutrin XL and Wellburin SR) should not be crushed so be sure you are not taking these types. To make crushed Wellbutrin more tolerable it would be recommended to mix it with a small amount of soft food such as applesauce or pudding, just enough for it to be taken in one or two bites so that it can be quickly swallowed. You may wish to follow it up with a beverage to help get rid of the taste. Take doses of Wellbutrin at least 6 hours apart. Wellbutrin can cause insomnia so it is best to avoid taking Wellbutrin at bedtime or very late in the day. Other common side effects associated with Wellbutrin include headache, agitation, dizziness, dry mouth, constipation, nausea and sweating. Patients taking Wellbutrin should avoid alcohol use. Alcohol can increase the risk of side effects such as drowsiness and dizziness. Be sure to inform your doctor and pharmacist of all the medications you take, including over the counter medications, vitamins, and herbal supplements so they can monitor for drug interactions. It is also important to discuss any adverse effects from medications with your doctor. Laura Cable, PharmD

Q: I take Wellbutrin and have no sex drive. Is Wellbutrin causing this?

A: Wellbutrin (bupropion) is a dopamine reuptake inhibitor antidepressant used to treat depression. The most common side effects with Wellbutrin are headache, insomnia, dry mouth, increased heart rate, weight loss, and nausea. Other side effects with Wellbutrin include decreased libido (sex drive). This is not a complete list of the side effects associated with Wellbutrin. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Laura Cable, PharmD

Q: I am currently taking 150 mg per day of Wellbutrin XL for treatment/management of my ADHD. I have been on this same dosage for about 6 to 7 years. I need to increase my dosage or adjust so that it is still working in the afternoon. The next dosage offered is 300 mg, which is too much. Is there any way to slightly increase my medication by splitting the pills in half?

A: Wellbutrin XL (bupropion XL) is an antidepressant that works on chemicals in the brain. Wellbutrin XL is indicated for depression. Side effects of Wellbutrin XL include headache, insomnia, nausea, dizziness, appetite changes and tremor or shaking. According to prescribing information, patients should be advised to swallow Wellbutrin XL whole so that the release rate is not altered. Do not chew, divide, or crush tablets, as this may lead to an increased risk of adverse effects, including seizures. Consult with your doctor about effectively increasing your dosage of Wellbutrin XL. There are other dosing options available for Wellbutrin besides the XL version. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kimberly Hotz, PharmD

Q: I am currently taking 150 mg per day of Wellbutrin XL for treatment/management of my ADHD. I have been on this same dosage for about 6 to 7 years. I need to increase my dosage or adjust so that it is still working in the afternoon. The next dosage offered is 300 mg, which is too much. Is there any way to slightly increase my medication by splitting the pills in half?

A: Wellbutrin XL (bupropion XL) is an antidepressant that works on chemicals in the brain. Wellbutrin XL is indicated for depression. Side effects of Wellbutrin XL include headache, insomnia, nausea, dizziness, appetite changes and tremor or shaking. According to prescribing information, patients should be advised to swallow Wellbutrin XL whole so that the release rate is not altered. Do not chew, divide, or crush tablets, as this may lead to an increased risk of adverse effects, including seizures. Consult with your doctor about effectively increasing your dosage of Wellbutrin XL. There are other dosing options available for Wellbutrin besides the XL version. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kimberly Hotz, PharmD

Q: What are the side effects of Wellbutrin?

A: Wellbutrin (bupropion) is an antidepressant that works on chemicals in the brain. Wellbutrin is indicated for depression. Wellbutrin is usually taken in the morning, either with or without food. Side effects of Wellbutrin include headache, insomnia, nausea, dizziness, appetite changes and tremor or shaking. Other side effects may include constipation, drowsiness, dry mouth, headache, increased sweating, nervousness and restlessness, taste changes, trouble sleeping and weight changes. Antidepressants, including Wellbutrin, can increase suicidal thoughts in some children, teenagers and young adults especially within the first few months of treatments. Tell the healthcare provider if suicidal thoughts or behaviors occur. Report to the healthcare provider if sudden changes in mood, behavior, thoughts or feelings occur. Also, let the doctor know if there is a risk of seizures. Do not crush, chew, or break an extended-release tablet. Breaking the pill may cause too much of the drug to be released at one time, which could increase side effects, including seizures. Wellbutrin can increase the risk of a seizure disorder. Do not stop taking Wellbutrin without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly. This is not a complete list of side effects associated with Wellbutrin, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Tell your healthcare provider if you experience any negative side effects from prescription drugs. For more specific information on Wellbutrin, or your current health status, consult with your healthcare provider. Kimberly Hotz, PharmD

Q: Are muscle spasms a side effect of Wellbutrin? I have had spasms throughout my body. My hands will make a fist, my upper torso will contract as if I am doing a sit-up, my feet will be forced into flexing up and down. I also have MS, but my neurologist says the spasms are not caused by MS. My psychiatrist says Wellbutrin is not responsible. I also take levothyroxine daily and Avonex IM once a week.

A: Wellbutrin (bupropion) is an antidepressant medication. It is used to treat major depression, seasonal affective disorder (SAD), and bipolar disorder. Wellbutrin may also be used for other purposes as determined by your doctor. According to the prescribing information for Wellbutrin, there are a wide variety of muscular side effects that have been reported with Wellbutrin. Frequent (occurring in at least one out of 100 patients) muscular side effects, seen during clinical trials of Wellbutrin, include ataxia, seizure, myoclonus, dyskinesia, and dystonia. Ataxia is an inability to coordinate muscles or a lack of coordination. Myoclonus is spasms or jerks of a muscle or muscle group. Dyskinesia is difficulty with voluntary movements, such as reaching for something and dystonia is problems with muscle tone. A decrease in dose or switching to another medication may help relieve muscular side effects. Do not stop or change the amount of medication you take without talking to your doctor first. This is not a complete list of side effects that can occur with Wellbutrin. For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications, particularly before taking any action. Sarah Lewis, PharmD

Q: Can I take vitamins while taking Wellbutrin SR?

A: Wellbutrin SR (bupropion) is an antidepressant medication that works by altering the levels of certain chemicals in the brain. There is no problem with taking multivitamins with Wellbutrin SR. However, some herbal products, especially St. John's wort, should not be taken with bupropion. Stopping bupropion abruptly has been reported to cause seizures in some patients. If you plan to stop taking bupropion, first consult with your physician. You may need to gradually reduce the dose of medication over the course of a few weeks in order to safely stop taking this medication. The most common side effects of bupropion include change in appetite, dizziness, constipation, drowsiness, dry mouth, headache, sweating, nausea, nervousness, restlessness, taste changes, trouble sleeping, vomiting, and weight changes. For more specific information, consult with your doctor, particularly before taking any action. Burton Dunaway, PharmD

Q: If I start taking Wellbutrin for depression, how long will I have to take it? Will it have an effect when I get off?

A: Wellbutrin (bupropion), is an antidepressant medication classified in the aminoketone drug class. Wellbutrin is chemically unrelated to other antidepressant medications. Wellbutrin is approved for the treatment of major depressive disorder. The efficacy of Wellbutrin was established in three clinical trials, two trials of about three weeks

Q: What can happen if a depressed person, who has been on Wellbutrin XL for 2 years, just stops taking it and they are still very depressed?

A: Wellbutrin (bupropion) is approved for the treatment of depression. Wellbutrin is in a class of medications known as aminoketones. Wellbutrin is not related to other antidepressant medications such as tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), or other antidepressant classes. The active ingredient in Wellbutrin, bupropion, is also marketed under the name Zyban, and is used for smoking cessation. According to the prescribing information for Wellbutrin XL, suddenly stopping an antidepressant medication, like Wellbutrin XL, may suddenly cause other symptoms. It is not usually advised to stop taking an antidepressant suddenly. Coming off of an antidepressant should be done under the supervision of a health care provider. Please consult with your health care provider in regards to your medication. If Wellbutrin XL is causing side effects that are making you want to stop taking it, or is not working optimally to control your symptoms of depression, talk to your doctor about other options available for the treatment of depression. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kristen Dore, PharmD

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